Key result
Opium consumption was independently associated with a 2.2-year earlier age of coronary artery disease diagnosis compared to non-users.
Why the study?
Coronary artery disease is a universal public health challenge, particularly in low- and middle-income countries, prompting investigation into risk factor trends and their impact on age of diagnosis.
What are the prevalence and trends of CAD risk factors and their effect on the age of diagnosis in patients with established CAD?
Cross-Sectional (n=90,094)
No
What are the prevalence and trends of CAD risk factors and their effect on the age of diagnosis in patients with established CAD?
Opium use is associated with a significantly younger age of CAD onset, highlighting it as an important risk factor for premature coronary artery disease.
Answers are grounded in this paper and cite their sources.
Opium use was associated with 2.2 years earlier CAD diagnosis; leaves open whether this warrants targeted screening or prevention trials.
BACKGROUND: Coronary artery disease (CAD) is a universal public health challenge, more prominently so in the low- and middle-income countries. In this study, we aimed to determine prevalence and trends of CAD risk factors in patients with documented CAD and to determine their effects on the age of CAD diagnosis. MATERIALS AND METHODS: We conducted a registry-based, serial cross-sectional study using the coronary angiography data bank of the Tehran Heart Center. Adult patients who had obstructive (> 50% stenosis) CAD were included in the study. The prevalence and 11-year trends of conventional CAD risk factors were analyzed by sex and age, and their adjusted effects on the age of CAD diagnosis were calculated. RESULTS: From January 2005 to December 2015, data for 90,094 patients were included in this analysis. A total of 61,684 (68.5%) were men and 28,410 (31.5%) were women. Men were younger at diagnosis than women, with a mean age of 60.1 in men and 63.2 in women (p < 0.001), and had fewer risk factors at the time of diagnosis. Mean age at diagnosis had an overall increasing trend during the study period. Increasing trend was seen in body-mass index, hypertension prevalence, diabetes mellitus. All lipid profile components (total cholesterol, low-density lipoprotein cholesterol, triglycerides, and high-density lipoprotein cholesterol) decreased over time. Of particular interest, opium consumption was associated with 2.2 year earlier age of CAD diagnosis. CONCLUSION: The major results of this study (lower age of CAD diagnosis in men, lower age of diagnosis associated with most risk factors, and lower prevalence of serum lipids over time) were expected. A prominent finding of this study is confirming opium use was associated with a much younger age of CAD onset, even after adjusting for all other risk factors. In addition to recommendations for control of the traditional risk factors, spreading information about the potential adverse effect of opium use, which has only recently been associated with higher risk of CAD, may be necessary.
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Hosseini et al. (2021) conducted a cross-sectional in Coronary artery disease (n=90,094). Opium consumption vs. No opium consumption was evaluated on Age of CAD diagnosis (MD -2.20 years, 95% CI -2.44, -1.96, p=< 0.001). Opium consumption was independently associated with a 2.2-year earlier age of coronary artery disease diagnosis compared to non-users.
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